Gender and human rights
Defining sexual health
Sexual and reproductive health and well-being are essential if people are to have responsible, safe, and satisfying sexual lives. Sexual health requires a positive approach to human sexuality and an understanding of the complex factors that shape human sexual behaviour. These factors affect whether the expression of sexuality leads to sexual health and well-being or to sexual behaviours that put people at risk or make them vulnerable to sexual and reproductive ill-health. Health programme managers, policy-makers and care providers need to understand and promote the potentially positive role sexuality can play in people’s lives and to build health services that can promote sexually healthy societies.
The past three decades have seen dramatic changes in understanding of human sexuality and sexual behaviour. The pandemic of human immunodeficiency virus (HIV) has played a major role in this, but it is not the only factor. The toll taken on people’s health by other sexually transmitted infections (STIs), unwanted pregnancies, unsafe abortion, infertility, gender-based violence, sexual dysfunction, and discrimination on the basis of sexual orientation has been amply documented and highlighted in national and international studies. In line with the recognition of the extent of these problems, there have been huge advances in knowledge about sexual function and sexual behaviour, and their relationship to other aspects of health, such as mental health and general health, well-being and maturation. These advances, together with the development of new contraceptive technologies, medications for sexual dysfunction, and more holistic approaches to the provision of family planning and other reproductive health care services, have required health providers, managers and researchers to redefine their approaches to human sexuality.
Sexual health was defined as part of reproductive health in the Programme of Action of the International Conference on Population and Development (ICPD) in 1994. Statements about sexual health were drawn from a WHO Technical Report of 1975 (1), which included the concept of sexual health as something “enriching” and that “enhance[s] personality, communication and love”. It went further by stating that “fundamental to this concept are the right to sexual information and the right to pleasure”.
In response to the changing environment, WHO, in collaboration with the World Association for Sexology (WAS), began a collaborative process (3) to reflect on the state of sexual health globally and define the areas where WHO and its partners could provide guidance to national health managers, policy-makers and care providers on how better to address sexual health. As in 1975, the process began with a review of key terminology and of the evidence, and culminated in the convening of a large group of experts from around the world to discuss the state of sexual health globally.
(1) Education and treatment in human sexuality: the training of health professionals. Geneva, World Health Organization, 1975 (WHO Technical Report Series No. 572).
(2). To obtain a better understanding of how sexuality and sexual health are viewed in different parts of the world, WHO commissioned 14 national and regional background papers, held four regional meetings or round table discussions and one international preparatory meeting, and established an interdepartmental working group within WHO headquarters as part of a collaborative consensus-building process.
(3) Education and treatment in human sexuality: the training of health professionals. Geneva, World Health Organization, 1975 (WHO Technical Report Series No. 572).